intra-abdominal mass

  • 文章类型: Case Reports
    在13岁的绝育母猫的腹部皮肤中发现了含有黑色颗粒状物质(直径1-2毫米)的脓液。腹部超声检查显示腹内大肿块,皮肤病变下方血流丰富。剖腹手术显示一个大肿块,粘附在脾脏和左肾上。在腹壁和肠系膜发现了类似的小病变。手术切除肿块以及脾脏和肾脏。组织病理学,肿块性病变包括肉芽肿伴色素性真菌,这只猫被诊断出患有真菌病。使用遗传分析,被鉴定为致病病原体。
    Pus discharge containing black granular materials (1-2 mm in diameter) was found in the abdominal skin of a 13-year-old sterilized female cat. Abdominal ultrasonography revealed a large intra-abdominal mass with abundant blood flow beneath the skin lesion. Laparotomy revealed a large mass that adhered to the spleen and left kidney. Similar small lesions were found in the abdominal wall and mesentery. The masses were surgically removed along with the spleen and kidney. Histopathologically, the mass lesions consisted of granulomas with lesional pigmented fungi, and the cat was diagnosed with phaeohyphomycosis. Uisng genetic analysis, the Exophiala dermatitidis was identified as the causative pathogen.
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  • 文章类型: Case Reports
    平滑肌瘤是从子宫肌层的平滑肌细胞和成纤维细胞中出现的非癌性肿瘤。它们是女性最常见的盆腔肿瘤,通常无症状。寄生平滑肌瘤已被定义为带蒂平滑肌瘤的不寻常变体。当出现症状时,平滑肌瘤可引起异常子宫出血,盆腔疼痛/压力,和生殖效应,如不孕症或不良妊娠结局。治疗因年龄而异,症状,以及保留生育能力的偏好。在这篇文章中,我们描述了一名58岁女性在初级卫生保健中接受定期宫颈癌筛查的案例.经客观审查,病人表现出腹部扩张和紧张,伴随着下肢水肿。这些症状与过去几个月的疲劳和体重增加有关。随后的调查导致剖腹探查,发现腹部有大量肿块,直径约45厘米,重35公斤。这些发现暗示了寄生性平滑肌瘤。
    Leiomyomas are non-cancerous tumors emerging from the smooth muscle cells and fibroblasts of the myometrium. They are the most common pelvic tumors in females and are usually asymptomatic. Parasitic leiomyomas have been defined as unusual variants of pedunculated leiomyomas. When symptomatic, leiomyomas can cause abnormal uterine bleeding, pelvic pain/pressure, and reproductive effects, such as infertility or adverse pregnancy outcomes. Treatment varies depending on age, symptoms, and the preference to preserve fertility. In this article, we describe the case of a 58-year-old woman who presented for a scheduled cervical cancer screening in primary healthcare. Upon objective examination, the patient exhibited a distended and tense abdomen, along with edema in the lower limbs. These symptoms were associated with fatigue and weight gain over the last few months. Subsequent investigation led to an exploratory laparotomy which revealed a massive abdominal mass, measuring approximately 45 cm in diameter and weighing 35 kg. The findings were suggestive of a parasitic leiomyoma.
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  • 文章类型: Case Reports
    副脾是一种先天性缺陷,其特征是通常位于脾门和胰尾的异位脾实质。它存在于大约10%-30%的人口中,一般来说,不会引起任何症状。
    我们报告了一个有趣的病例,其中有症状的肠系膜副脾通过超声造影检测并表征。患者经历了左上腹间歇性疼痛的长期病史。术后病理检查证实诊断。
    副脾通常表现为界限良好的卵形肿块,直径1-3厘米,很少位于肠系膜。由于并发症,它很少会出现症状。将这种情况诊断为腹部原因是困难的,很少在术前进行。计算机断层扫描和磁共振成像可能会有所帮助,但是应该用静脉注射造影剂进行,他们不能提供患者疼痛和病变之间的直接证据。相反,实时超声可以评估和诊断病变,显示与患者腹痛的确切对应关系。此外,超声和超声造影广泛可用,安全且相对便宜。
    除了这种情况的稀有性,本病例报告显示超声定位肠内副脾的能力,评估病变与患者症状之间的关系,并描述病变的特征。
    UNASSIGNED: Accessory spleen is a congenital defect characterised by a separated ectopic splenic parenchyma usually located in the splenic hilum and the tail of the pancreas. It is present in about 10%-30% of the population and, generally, does not cause any symptoms.
    UNASSIGNED: We report an interesting case of a woman with symptomatic intramesenteric accessory spleen detected and characterised by contrast-enhanced ultrasound. The patient experienced a long history of intermittent pain in the left upper abdomen. The diagnosis was confirmed by post-operative pathology examination.
    UNASSIGNED: Accessory spleen usually appears as a well-circumscribed ovoid mass, 1-3 cm in diameter, infrequently located in the mesentery. It may rarely become symptomatic because of complications. Diagnosis of this condition as a cause of abdominal is difficult and rarely has been made pre-operatively. Computed tomography and magnetic resonance imaging might help, but they should be performed with intravenous contrast injection, and they cannot provide direct evidence between the pain of the patient and the lesion. Conversely, real-time ultrasound can assess and diagnose the lesion showing the exact correspondence with abdominal pain of the patient. Furthermore, ultrasound and contrast-enhanced ultrasound are widely available, safe and relatively inexpensive.
    UNASSIGNED: Apart from the rarity of this condition, this case report demonstrates the ability of ultrasound to localise the intramesenteric accessory spleen, assess the relationship between the lesion and the symptoms of the patient, and characterise the lesion.
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  • 文章类型: Case Reports
    Uterine fibroids are the most common benign pelvic tumors in females of the reproductive age group. Usually, fibroids are confined to the uterus. Here, we report an interesting and rare case of a large 17 cm abdominopelvic mass lesion that led to a diagnostic dilemma between a mesenteric gastrointestinal stromal tumor (GIST) and a uterine fibroid. We had a 26-year-old female who underwent an ultrasound examination of the abdomen as the initial imaging modality and was found to have an abnormally large solid abdominopelvic mass lesion. For further evaluation, a contrast-enhanced CT examination of the abdomen-pelvis was done. Initially, on first look, the mass was thought to be of mesenteric origin, but on further review of images, it was found to be of gynecological origin. Intraoperatively, the solid mass was seen attached to the uterine fundus and underwent excision. Histopathological examination confirmed the mass to be a uterine fibroid. This case study describes the uncommon appearance of this tumor in a young woman, including the clinical presentation, imaging, and surgical findings.
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  • 文章类型: Journal Article
    腹膜后纤维瘤病是一种罕见的良性间充质肿瘤,由于肌膜膜间质内的成纤维细胞增殖而发展。作者介绍了一名41岁的男性患者,该患者因腹膜后肿瘤而转诊。做了肠系膜肿块穿刺活检,显示低度梭形细胞病变,与纤维瘤病一致。
    Retroperitoneal desmoid-type fibromatosis is a rare benign mesenchymal neoplasm that develops as a result of fibroblastic proliferation within the musculoaponeurotic stroma. The authors present the case of a 41-year-old male patient who was referred for a retroperitoneal neoplasm. A mesenteric mass core biopsy was done, and it revealed a low-grade spindle cell lesion consistent with desmoid fibromatosis.
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  • 文章类型: Case Reports
    由于腹腔镜胆囊切除术的使用增加,胆结石溢出和胆囊穿孔的发生率增加。腹部胆结石的存在可能导致粘连,炎症,感染,胆管阻塞.由于胆结石的溢出可能会发生不同的病因,预计演示文稿会有所不同。我们报告了4年手术后腹腔镜胆囊切除术并发症的病例。患者的临床表现模仿恶性肿瘤。
    The incidence of gallstone spillage and gallbladder perforation has increased as a result of the rising use of laparoscopic cholecystectomy. The presence of gallstones in the abdomen may lead to adhesions, inflammation, infection, and obstruction of biliary ducts. Since different etiologies can occur with spillage of gallstones, variation in presentation is expected. We report a case of a laparoscopic cholecystectomy complication after four years of surgery. The patient\'s clinical presentation mimicked malignancy.
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  • 文章类型: Case Reports
    未经证实:在怀孕期间诊断为恶性潜能不确定的平滑肌肿瘤(STUMP)是罕见的。此外,由于解剖变化以及对发育中的胎儿和辐射暴露的额外考虑,怀孕期间腹内肿块的研究在临床上具有挑战性。这种病例的不寻常性质和诊断困境需要病例报告作为可能遇到妊娠患者腹部未分化肿块和/或怀疑STUMP的临床医生的教育提示。
    方法:我们报告了一例罕见的在怀孕期间诊断为寄生虫STUMP的病例。该患者在妊娠晚期接受了新的脐疝和肝脏功能紊乱检查(LFT)。MRI报告左侧中部有一个大肿块,腹内静脉曲张延伸到脐疝。她继续发展为急腹症,需要进行剖腹手术,其中切除了粘附在网膜上的寄生虫纤维瘤,并通过剖腹产分娩了早产儿。由于与妊娠相关的变化,组织学很难,但最终证实了STUMP的诊断。
    UNASSIGNED:妊娠中的STUMP很少见,由于与妊娠相关的变化,组织学挑战使诊断进一步复杂化。由于缺乏普遍接受的诊断标准,术后诊断具有挑战性,并且预后因素的不确定性使STUMP患者的治疗和随访具有挑战性。研究表明,年轻患者更有可能出现复发。
    结论:妊娠期腹腔内肿块的调查和处理具有挑战性。它需要及时的多学科团队(MDT)投入。其他并发症和注意事项与早产胎儿有关。对这些困难的知识和理解将更好地使与此类患者一起工作的临床医生为具有新的腹内肿块的怀孕患者制定结构化且消息灵通的方法。妊娠期间STUMP的诊断可能对病理学家具有挑战性,需要进一步发表意见。
    UNASSIGNED: Diagnosis of a smooth muscle tumor of uncertain malignant potential (STUMP) during pregnancy is rare. Furthermore; the investigation of an intra-abdominal mass during pregnancy is clinically challenging due to anatomical changes and additional considerations of the developing fetus and radiation exposure. The unusual nature and diagnostic dilemma of such a case warrants a case report to serve as an educational prompt to clinicians who may encounter pregnant patients with undifferentiated intra-abdominal masses and/or suspecting of STUMP.
    METHODS: We report a rare case of a parasitic STUMP diagnosed during pregnancy. The patient presented with a new umbilical hernia and deranged liver function tests (LFT\'s) during her third trimester. MRI reported a large mass in the left mid flank with intra-abdominal varices extending into the umbilical hernia. She went on to develop an acute abdomen requiring laparotomy where a parasitic fibroid adherent to the omentum was excised and a preterm infant was delivered via caesarean section. Histology was difficult due to pregnancy related changes but ultimately confirmed a diagnosis of STUMP.
    UNASSIGNED: STUMP in pregnancy is rare and diagnosis is further complicated by histological challenges due to pregnancy related changes. Postoperative diagnosis is challenging due to lack of universally accepted diagnostic criteria and Uncertainty regarding prognostic factors makes management and follow-up of patients with STUMP challenging. Studies have shown that younger patients are more likely to demonstrate recurrence.
    CONCLUSIONS: Investigation and management of intra-abdominal masses in pregnancy is challenging. It requires timely multi-disciplinary team (MDT) input. Additional complications and considerations relate to the preterm fetus. Knowledge and understanding of these difficulties will better equip clinicians working with such patients to formulate a structured and well informed approach to the pregnant patient with a new intra-abdominal mass. Diagnosis of STUMP during pregnancy may be challenging for the pathologist and require further exert opinion.
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  • 文章类型: Journal Article
    该报告描述了由28个月大的日本黑母牛的腹腔中含有黄体酮的受控内部药物释放(CIDR)装置引起的腹内肿块。直肠检查显示盆腔中有一个含有软骨样物体的肿块。计算机断层扫描显示一个包含两个T形异物的肿块。进行剖腹手术以去除含有异物的肿块。小母牛在手术后七天出院时是健康的。此病例将CIDR装置作为腹腔内肿块的新病因。此外,它强调了CT在诊断腹部深部病变中的有用性。
    This report describes an intra-abdominal mass caused by progesterone-containing controlled internal drug release (CIDR) devices in the abdominal cavity of a 28-month-old Japanese Black heifer presenting with infertility. Rectal examination revealed a mass containing a cartilage-like object in the pelvic cavity. Computed tomography revealed a mass containing two T-shaped foreign bodies. Laparotomy was performed to remove the mass containing the foreign bodies. The heifer was healthy at discharge seven days post-surgery. This case adds CIDR device as a new etiology for intra-abdominal masses. Furthermore, it highlights the usefulness of CT in diagnosing deep abdominal lesions.
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  • 文章类型: Journal Article
    背景:这项研究的目的是回顾性和多中心地检查诊断为肠系膜囊肿的患者的临床病理特征,这是过去9年中引起腹内肿块的罕见原因,从文学的角度来看。
    方法:患者于2010年至2019年在两家培训研究医院的普外科诊所接受肠系膜囊肿手术;年龄,性别,术前临床发现,计算机断层扫描(CT)的发现,质量的本地化,外科手术,发病率,组织病理学结果,并以电子方式分析和报告随访期状态.
    结果:患者通常以腹痛为主诉,可触及的腹部肿块,腹胀.其中男性14例(63.7%),女性8例(36.3%)。肠系膜囊肿位于小肠18例,结肠4例。在手术材料的组织病理学检查中,17例检出单纯性囊肿,4例淋巴管瘤,结肠腺癌,单纯性囊肿1例。在术后期间,由于吻合口漏,3例患者发生浅表手术部位感染,1例患者发生发病率。
    结论:虽然肠系膜囊肿很少见,尽管它们中的大多数在组织病理学上不是恶性的,它们可以达到大尺寸,需要大量的外科手术,可以看到相关的发病率。因此,肠系膜囊肿在术后以及诊断和手术治疗过程中应仔细随访。
    BACKGROUND: The aim of this study is to retrospectively and multi-centerly examine the clinicopathological features of patients who were operated with the diagnosis of mesenteric cyst, which is a rare cause of intra-abdominal mass in the last 9 years, in the light of the literature.
    METHODS: The patients were operated due to mesenteric cysts in the general surgery clinics of two Training and Research Hospital between 2010 and 2019; age, gender, preoperative clinical findings, computed tomography (CT) findings, localization of the mass, surgical procedure, morbidity, histopathological results, and follow-up period status were analyzed and reported electronically.
    RESULTS: The patients generally applied with the complaints of abdominal pain, palpable abdominal mass, and abdominal distention. Fourteen (63.7%) of the cases were male and 8 (36.3%) were female. The mesenteric cysts were located in the small intestine in 18 cases and colon in 4 cases. In the histopathological examination of the surgical materials, simple cyst was detected in 17 cases, lymphangioma in 4 cases, colon adenocarcinoma, and simple cyst in 1 case. In the postoperative period, superficial surgical site infection developed in 3 patients and morbidity developed in 1 patient due to anastomotic leakage.
    CONCLUSIONS: Although mesenteric cysts are rarely seen, although most of them are not histopathologically malignant, they can reach large sizes and require extensive surgical operation, and related morbidities can be seen. Therefore, mesenteric cysts should be followed carefully in the postoperative period as well as during the diagnosis and surgical treatment process.
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  • 文章类型: Case Reports
    UNASSIGNED: Over the years, the robotic surgery is gaining increasing importance in the treatment of bladder cancer. Some doubts remain about the oncological safety of robotic approach and alerts have been raised about the occurrence of atypical recurrences, including peritoneal carcinomatosis and port-site metastasis.
    UNASSIGNED: The patient referred to our Emergency Department because of acute confusional state probably due to severe anemia and sepsis. A left nephroureterectomy, left hemicolectomy with end colostomy and the surgical excision of the huge mass was performed through a xipho-pubic incision associated to another left peri-stomal incision. The histological specimen analysis showed a high-grade sarcoma, not otherwise specified (sarcoma, NOS-type), measuring 29 cm × 8 cm × 5 cm in diameters. The left kidney and ureter were not infiltrated by the neoplasm while serosa membranes and muscular layers of left colon were infiltrated by the mass. The patient died because of a cardiac arrest 4 days after surgery.
    UNASSIGNED: RARC is a safe and feasible alternative to open radical cystectomy (ORC) with satisfactory operative time, little blood loss, and low transfusion rates. Despite this, RARC is associated with a low, but not neglectable, risk of atypical metastases like peritoneal implants and port-site metastasis. Although a small amount (7%) of RARC were performed in non-urothelial variants of bladder cancer, the sarcomatoid one can be related to a greater risk of atypical recurrence and special precaution should be taken to reduce potential causes of tumor seeding.
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